This proposed Senior Research Career Scientist award is to support the activities of Dr. Kelli Allen, an established Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) investigator, allowing her to her expand her scientific, mentoring and service contributions. Dr. Allen?s research focuses on improving care and outcomes for patients with chronic musculoskeletal (MSK) conditions, particularly osteoarthritis. The majority of Dr. Allen?s research has been conducted in the VA healthcare system. MSK conditions are among the most prevalent and disabling conditions among Veterans, who bear a greater burden of these health problems compared with the general population. In addition, research by Dr. Allen and others has shown that there are gaps in quality of care for MSK conditions, including underutilization of first-line, evidence-based treatments such as physical therapy and behavioral interventions. To address these important challenges, Dr. Allen?s research particularly focuses on conducting pragmatic and effectiveness trials of behavioral and health services interventions for patients, particularly Veterans, with chronic MSK conditions. The goal of these trials is to develop and test programs and delivery models that can be implemented in the VA, as well as other healthcare systems, to improve care quality, efficiency and patient- centered outcomes. Dr. Allen has led eight randomized controlled trials of interventions for MSK conditions, as well as a number of pilot and observational studies in this research area. Among trials Dr. Allen has led, intervention approaches have included telephone-based patient programs (self-management, physical activity, weight management, cognitive behavioral therapy for pain), a primary care provider-based approach to improve osteoarthritis management, group-based physical therapy, internet-based exercise programs, and a stepped care approach to increasing physical activity and function in patients with osteoarthritis. One example of a health system impact resulting from Dr. Allen?s research is the local VA implementation of a group-based physical therapy program for osteoarthritis, which was found to be as effective as individual physical therapy but requires fewer resources and can improve access. Dr. Allen has also been a co-investigator on many MSK studies, including five active trials of diverse care models and intervention approaches for treating osteoarthritis and chronic low back pain. As a co-investigator, Dr. Allen?s contributions focus on methodologies for conducting large pragmatic trials. In addition to Dr. Allen?s research activities, she has contributed to many national and international committees and leadership panels. Recent activities include service on VA HSR&D grant review panels, the steering committee for HSR&D State of the Art Meeting on Non-Pharmacological Pain Management, and the VA Pain Measures Work Group. She is also an Associate Editor for Osteoarthritis and Cartilage, a leading orthopedic journal. The protected time allowed by a VA HSR&D Senior Research Career Scientist award will allow Dr. Allen to enhance her contributions to the VA HSR&D mission, with a focus on improving care for Veterans with chronic MSK conditions, as well as enhancing the conduct of pragmatic trials in the VA. In addition to increasing her overall participation in local and national VA committees, Dr. Allen?s proposed activities for the award period include: 1) Leading a broad effort to understand heterogeneity of treatment effects in MSK conditions, 2) Developing and leading a national work group to enhance and facilitate pragmatic trials in the VA and 3) Increasing mentorship of junior investigators with expertise and interests in care models and quality for chronic MSK conditions.